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Paediatric Pulmonology and Allergology
2008 October, Vol. XI, No. 2 (3940-3950)
IMPACT OF LEUKOTRIENES RECEPTOR ANTAGONISTS TREATMENT ON THE ASTHMATIC YOUNG CHILDREN LUNG FUNCTION
Laimute Vaideliene
Clinic of Children’s Diseases of Kaunas Medical University, Kaunas, Lithuania
Objective lung function measurements are routinely used for asthma diagnose and management, but their utility for young children has not been defined. Impulse Oscillometry (IOS) requires only passive cooperation, so has been successfully used in young children. The aim of this study was to compare results of conventional spirometry and IOS in asthmatic and non-asthmatic 4–5 years old children, and to evaluate their lung function response to bronchodilators and anti-inflammatory treatment.
Results. Spirometry data showed no difference between non-asthmatic and asthmatic preschool children during remission. IOS data showed a significant increase of the distal capacitive reactance X5 in asthmatic children (105.4% vs 91.8%), p = 0.003. No difference was found in response to bronchodilators between two groups using spirometry. However, IOS showed a significant falling-down of total airway resistance R5 in asthmatic children (ΔR5 – 23.5% vs 16.5%), p = 0,014. 4 weeks treatment of asthmatic children with montelukast changed IOS parameters of distal airway resistance significantly: ΔR5–R20 – 0.14 kPa/l/s , ΔX5 (– 27.5%), ΔFres –2.4 l/s; p < 0.05.
Conclusion. Evaluation of airway resistance in 4–5 years children, using IOS, enables us diagnose airway obstruction earlier, in comparison with spirometry. Bronchodilator test, using spirometry, is usually negative during remission in todlers, though IOS measurement might be valuable when evaluating subclinical lung function changes after bronchodilator. 4 weeks montelukast treatment period had greater impact on lung function, than bronchodilator test with salbutamol. Significant change of airway resistance and peripheral reactance using IOS, demonstrates the effectiveness of montelukast in reduction of airway resistance – one of the most important pathophysiologic simptoms of asthma.